Mildew and pregnancy

Thrush (candidiasis) is a common disease in women, often occurring during pregnancy. Thrush is caused by the Candida fungus (yeast-like) and occurs in the genitourinary system of the female body.

Pregnancy is always a strong shock for a woman's body. At this time, hormonal changes occur, immunity decreases due to the fact that the immune system is redirected to the fetus and is responsible for its preservation and safety. Thus, favorable conditions are created for all kinds of infections to penetrate the body and develop favorably there.

It is considered normal for a woman's body to have a small amount of Candida fungus. Usually, it does not manifest itself in any way, since it is suppressed by the immune system. But as soon as a woman becomes pregnant, the fungus, due to the above circumstances, finds loopholes to begin active reproduction and increase its amount in the woman's body.

Pregnant women, compared to non-pregnant women, have a higher risk of developing thrush from locally applied suppositories and vaginal tablets containing antibiotics.

The fact is that one of the effects of antibiotics is the suppression of both parasitic microorganisms and physiological lactobacilli, which are less resistant throughout the entire period of pregnancy.

Thrush that occurs during pregnancy is very rarely transmitted sexually (only 15-20% of patients). Most often, sexual contact is just a trigger for thrush to develop.

Causes of thrush during pregnancy

The causes of thrush during pregnancy may be factors such as:

• Chronic infection in the genitourinary system. When the immune system fights chronic inflammation, it can become exhausted and manifest itself, among other things, as thrush.
• The presence of chronic diseases in the kidneys, liver and other organs. The mechanism of the immune system's reaction is similar to that described above.
• Thrush can develop due to hormonal imbalances: decreased thyroid function, diabetes, obesity.
• Candidiasis can be provoked by taking hormonal drugs such as Prednisolone, Dexamethasone, and Metipred.
• The presence of genital herpes can also cause thrush.
• Thrush can be caused by taking antibiotics, which could cause immunodeficiency and intestinal dysbacteriosis. Candida fungus can often stay in the intestines for some time, it is a kind of reservoir for candidiasis in the woman's body, and then move to other places.
• With improper nutrition, for example, an excess of sweets, dysbacteriosis can also develop and fungi can multiply.
• The cause of thrush may be the presence of chronic diseases of the intestinal tract.
• Candidiasis can occur due to improper use of drugs such as eubiotics. For the treatment of vaginal flora, drugs containing lactic acid bacteria (lactobacterin, acylact) are prescribed. They live in the vagina in a normal state of the body, are needed to maintain an acidic environment in it, prevent the development of alkali-loving bacteria, the presence of which can cause bacterial vaginosis. But the environment of lactic acid bacteria is favorable for Candida fungi, so before prescribing eubiotics, it is better to make a diagnosis for the absence of fungi.

Thrush is a kind of marker of an unfavorable state of the body, therefore, to eliminate it, both specific treatment with antifungal drugs and a full examination are necessary, as well as the elimination of the underlying causes that caused the immunodeficiency.

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Symptoms of thrush during pregnancy

The main symptoms of thrush during pregnancy include:

• itching at the vestibule of the vagina;
• vaginal discharge - white, cheesy, quite abundant, with a sour yeast smell;
• discomfort in the perineal area.

The presence of thrush during pregnancy, like any other infection, is potentially dangerous for both the expectant mother and her baby. The course of pregnancy is complicated, the fungus can infect the fetus.

The fetus becomes infected through the placental barrier or during childbirth. Then the baby may have congenital candidal stomatitis, candidiasis of the skin.

Therefore, although thrush is quite common in pregnant women, its presence is abnormal (although there is an outdated idea that thrush is a normal, natural and harmless phenomenon). At the slightest suspicion of thrush, it is necessary to immediately conduct diagnostics and prescribe treatment.

Thrush and itching during pregnancy

Many people do not take thrush seriously, saying that it is just a little discharge and itching. It is important to remember that this is a serious disease caused by a special type of fungi and requires special treatment. In addition, similar symptoms are observed in a number of diseases caused by completely different infections, so it is extremely important to be diagnosed by a specialist who will establish the correct diagnosis and prescribe the appropriate treatment. A visit to the doctor should not be delayed under any circumstances, especially during pregnancy, because candidiasis is dangerous for the child and his health. After a course of appropriate medications prescribed by the doctor, usually after a week to ten days, a repeat smear is taken or a bacteriological (cultural) study is carried out to determine whether the thrush has been eliminated during pregnancy.

Diagnosis of thrush during pregnancy

To diagnose thrush during pregnancy, the first test immediately after the symptoms of the disease are detected is bacterioscopy. The stained smear is examined for flora using a microscope.

The normal vaginal microflora consists of: Doderlein bacilli (lactic bacteria). The smear contains them together with epithelial cells and leukocytes in small quantities. When spores or mycelium of the Candida fungus are found in the smear, a diagnosis of thrush is made. Sometimes this fungus can be present in single quantities without causing disease.

When symptoms characteristic of thrush are present, but bacterioscopy does not reveal fungi, more sensitive diagnostic methods are used – bacteriological and PRC.

The bacteriological (cultural) method involves collecting the culture with a special nutrient medium - Sabouraud's medium. Its essence lies in the fact that the collected fungal cells are immediately placed in favorable conditions, so they can immediately begin to multiply, thereby confirming that they are present in the smear and are viable, while without placing them in special conditions in the smear they might not have shown themselves.

The PCR (polydimensional chain reaction) method is also used. The essence of its action is to detect single DNA molecules of the pathogen in the material taken for examination. The sensitivity of this method exceeds all other methods used to diagnose the presence of infection. It is used in cases where the pathogen is difficult to detect in a simple smear and which does not grow well in a normal nutrient medium. However, this method is rarely used to diagnose thrush, since it is unreasonably expensive, labor-intensive and often shows a positive result, even when the pathogen is present in small quantities (and in candidiasis, a small amount of fungus can often be a completely normal phenomenon that does not cause disease).

Therefore, diagnosis is usually made after symptoms have been identified using bacterioscopy and/or culture.

Thrush is not considered a classic sexually transmitted disease. Thrush is accompanied by a special internal condition in which immunity is reduced. Therefore, in cases where candidiasis is sluggish, recurrent and difficult to treat, its cause may be a pathology in the body, which is accompanied by immunodeficiency, and manifests itself as thrush. During pregnancy, hormonal levels decrease due to the fact that the immune system works in a special mode, therefore this state of affairs in the body favors the development of fungi. Nevertheless, you should always be attentive to the slightest changes in the body and, at the slightest suspicion, conduct diagnostics in order to start treatment in time and prevent danger to the body and the favorable course of pregnancy.

Treatment of thrush during pregnancy

Although candidiasis is an internal condition, it is quite sexually transmitted. Therefore, a course of treatment is prescribed to both partners, during this period, a condom must be used for sexual intercourse.

Treatment of thrush is characterized by the use of systemic and local drugs. Systemic drugs are tablets that the patient takes orally. At first, they affect the intestinal environment, then are absorbed into the blood and penetrate to the organs and tissues of the human body. For non-pregnant patients, this is the main and most preferable method, in contrast to local treatment (suppositories, creams). The fact is that most fungi are in the intestinal tract and for effective treatment they must be destroyed first. In addition, the habitat of the Candida fungus is also the thickness of the vaginal walls, where local drugs cannot reach - their area of activity is the surface, they only help reduce the manifestations of the disease, but do not kill the pathogen completely. Systemic drugs act through the blood on all organs. However, during pregnancy, not all systemic drugs can be used to treat thrush, many of them are toxic and have side effects. Usually, pregnant women suffering from thrush are prescribed only the ineffective “Nystatin” and “Pifamucin” of all systemic drugs.

"Pifamucin" is an antifungal drug that is not harmful during pregnancy and breastfeeding. It is quite effective and non-toxic even in small doses. Other drugs that are systemic - "Fluconazole" ("Diflucan"), "Levorin", "Nizoral" and many others - should not be used during pregnancy under any circumstances.

Local treatment includes the use of suppositories, vaginal tablets and creams. This method of treatment is usually combined with systemic drugs, and is also preferable during pregnancy.

The drugs for local treatment are the same. Usually, suppositories with nystatin, suppositories or cream with pimafucin are used. The drug "Clotrimazole" ("Canesten"), which is very often used to treat candidiasis in non-pregnant women, should never be used during the first trimester of pregnancy, and it is also undesirable to use it at later stages.

Vaginal tablets and suppositories for the treatment of thrush are inserted deep into the vagina every night before bed for 10 days.

In addition to the fact that specific antifungal drugs are used to treat thrush, it is possible to use antiseptic and anti-inflammatory agents common in folk treatment methods. Widely used is a solution of sodium tetraborate in glycerin (borax in glycine), as well as ordinary brilliant green. The essence of their action is the mechanical removal of the mycelium of the fungus living on the walls of the vagina, stopping their growth, providing an anti-inflammatory effect, eliminating complaints and symptoms. A characteristic feature of the use of these drugs is the absence of side effects, so they are often chosen for treatment during the first trimester of pregnancy, while the use of other drugs is strictly prohibited. A gauze swab is moistened in the solution, and then the walls of the vagina are wiped with it.

The iodine preparation "Betadine", widely used to treat thrush in non-pregnant patients, is also contraindicated during pregnancy - it affects the baby's thyroid gland and can lead to disturbances in its formation.

Although the Candida fungus lives in the body of almost every woman, and pregnancy predisposes to their reproduction, not all pregnant women suffer from thrush. First of all, the exacerbation of thrush is affected by immunodeficiency, so if candidiasis does not respond to easy and final treatment, most likely there is a serious chronic pathology in the body. Therefore, it is important to include general tonic and immunomodulatory drugs in the general treatment regimen for the disease. In addition, multivitamins are prescribed, since the presence of hypovitaminosis is a common cause causing immunodeficiency, contributing to the creation of a favorable background for the side effects of many drugs. As immunomodulators, rectal suppositories containing Viferon are used during pregnancy.

If we talk about probiotics, which contain beneficial microorganisms already present in the human body, then during the treatment of thrush, you can take only drugs with bifidobacteria. Candidiasis does not contribute to the suppression of lactobacilli, so there is no need to take them additionally, plus lactobacilli contribute to even more active reproduction of fungi.

It is important to remember that the course of treatment for thrush during pregnancy must be prescribed only by the attending physician, who is familiar with the individual characteristics of the expectant mother, her tendency to allergies, knows the condition of her liver and kidneys, how the pregnancy is progressing, what pathologies are associated. It is better never to self-medicate, and especially during the period of bearing a baby, because incorrect treatment measures can be dangerous to the health of not only the mother, but also her child.

The husband of the pregnant woman should also be treated for thrush, no matter whether the couple continues sexual activity during the pregnancy or not. The man can take any of the effective drugs, including Fluconazole, Nizoral and others.

Prevention of thrush during pregnancy

90% of pregnant women suffer from candidiasis. This disease is highly undesirable during pregnancy, as it can seriously affect not only the course of the pregnancy itself, but also the health of the future baby. There are several simple methods for preventing thrush:

• Strengthening the immune system. This measure is especially important, since it is the immunodeficiency that often becomes the impetus for the proliferation of Candida fungi and the development of the disease. The diet should be enriched with products rich in probiotics: biokefir, yogurts with live bacteria. Prebiotics, such as bananas and garlic, will also help prevent thrush. If you have to undergo treatment with an antibiotic, it is important to ensure that the doctor prescribes a drug that is gentle on the intestinal microflora or prescribes medications to soften the effect of the antibiotic.
• Wearing comfortable, loose-fitting underwear, preferably made from natural fabrics. Synthetics, due to their tight fit to the body, complicate air circulation around the genitals, which contributes to the creation of ideal conditions for bacteria to multiply. It is better to refuse to use daily pads, as they also help the fungus to develop.
• Maintaining good hygiene. Instead of scented shower gel and soap, it is better to use unscented intimate hygiene products or mild soap.
• Conducting an examination for the presence of harmful bacteria. Any infection of the genitals can negatively affect the course of pregnancy and contribute to the development of chronic vaginal candidiasis. Therefore, it is better to worry in advance and eliminate the likelihood of the disease.

Planning pregnancy and thrush

When a woman plans to become pregnant, it is worthwhile to undergo a full examination by a gynecologist, including a full range of laboratory tests and, if necessary, pre-treat all existing diseases that can affect the course of pregnancy, the formation of the fetus and the health of the future baby, including thrush. There are widespread cases when a woman infected with thrush does not use protection, believing that she will not be able to get pregnant, since the reproductive system allegedly does not work. But this is not true, it is quite possible to get pregnant with thrush. If it so happens that during the activation of thrush a woman becomes pregnant, it is necessary to cure the disease as soon as possible. Naturally, the treatment should be prescribed by a doctor so that it is certainly gentle and at the same time effective, and at the same time suitable for a pregnant woman.

Thrush during pregnancy is dangerous to the health of not only the mother, but also her baby.

The placenta allows the Candida fungus to pass to the fetus, it can affect the internal organs, lead to malformations, premature death of the unborn child. If the fetus becomes infected with thrush in the first trimester of pregnancy, it can be incredibly dangerous for it, up to the point that a miscarriage may occur. But even if a miscarriage does not occur, infection of the fetus can lead to a strong weakening of the baby's body. A newborn child infected with thrush is in great danger: unlike an adult, for whom this disease does not pose a serious threat, a baby can develop extremely complex diseases because of it. Often, thrush leads to the development of candidal stomatitis, when the pathogen contributes to the disease of the mucous membrane of the oral cavity of the child. Therefore, it is so important to prevent thrush at the stage of pregnancy planning, so as not to treat it later either during pregnancy or, especially, after the birth of the child.